Provider Demographics
NPI:1609637701
Name:NOBLE HEALTHCARE INC
Entity Type:Organization
Organization Name:NOBLE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED ZACCHEUS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-234-6433
Mailing Address - Street 1:1566 N OBERLIN CIR
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-6030
Mailing Address - Country:US
Mailing Address - Phone:763-913-6753
Mailing Address - Fax:763-600-6102
Practice Address - Street 1:1566 N OBERLIN CIR
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-6030
Practice Address - Country:US
Practice Address - Phone:763-913-6753
Practice Address - Fax:763-600-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health